Welcome to the inaugural post of my new weekly series: ASK HEIDI
I find some questions pop up more than others and I will start the series answering THOSE questions, but going forward I hope folks will email, tweet, private message, or post questions on my Facebook and I will answer them anonymously on here.
To kick things off I thought I’d start with something that I think everyone under the age of 65 confuses: Medicare versus Medicaid. The names are so similar they beg confusion, however, Medicare and Medicaid are very different. Granted, both are kinds of health insurance offered through government entities, but they have extremely different eligibility requirements, provide different levels of coverage and when planning ahead it’s crucial to understand the nuances.
What is Medicare?
Medicare, a federal health insurance program, is offered to those who are 65 and older or to those who have been declared disabled by the Social Security Administration. Medicare is administered by the Department of Health and Human Services, Centers for Medicare and Medicaid Services. Income or personal assets do not impact eligibility.
When you become enrolled in Medicare, you automatically have Part A, which covers hospital care, skilled nursing facility care, hospice and some home health services. Part B, which is medical coverage, costs $104.90 per month during 2015. Medically necessary services and preventive services are covered by Part B. You can enroll in Part A without enrolling in Part B.
If you are needing prescription coverage, you can enroll in Part D, which also is optional. There is a charge for Part D coverage, but you may qualify for reduced or free premiums depending on your income. There are several different providers offering Part D coverage, so you need to compare the coverage with your prescriptions to ensure you make the best selection for your needs.
*Official site https://www.medicare.gov/
What is Medicaid?
Medicaid is a health insurance that is offered through a partnership between the state and federal governments. It provides health coverage to those who meet special eligibility requirements. It was created to help improve the health of those who otherwise may not be able to seek medical care due to limited financial resources.
Because Medicaid is offered through a state partnership, its guidelines and eligibility requirements vary from state to state. In Florida, the Agency for Health Care Administration is responsible for Medicaid. During 2014, the Statewide Medicaid Managed Care (SMMC) program was implemented, which means if you are eligible for Medicaid you enroll in a health plan.
Sometimes people apply for Medicaid to cover the costs of long-term care, such as services provided by a nursing home. Medicare does not cover those expenses for you [after a limited initial period], so if you don’t have adequate insurance coverage of your own, you may have to apply for Medicaid to cover the costs of your medical coverage if you need long term care.
*Official Florida Medicaid site http://www.fdhc.state.fl.us/medicaid/
You can be eligible for both Medicare and Medicaid. In those situations, the two providers work together to cover the costs of medical expenses. You need to show proof of both kinds of coverage to your medical providers.
Important Things to Remember
Your income and assets do not affect your eligibility for Medicare, but they do however impact your Medicaid eligibility. Medicaid is only offered to those who are low income, meeting the eligibility guidelines set by your state, and do not have assets that exceed the specified limits. Medicaid eligibility and some ins and outs are issues I hope to touch upon in this series but if you feel you could benefit from personalized information, I am happy to schedule a free 30 minute consultation to see if I can offer assistance.
About Heidi S. Webb, Attorney at Law: Heidi Webb is an Estate Planning and small business attorney located in Daytona Beach, Florida. See what clients are saying about Heidi, follow her on Facebook, and connect with her on Google+ or LinkedIn.